PMID- 29121870
OWN - NLM
STAT- MEDLINE
DCOM- 20180710
LR  - 20191210
IS  - 1471-2393 (Electronic)
IS  - 1471-2393 (Linking)
VI  - 17
IP  - 1
DP  - 2017 Nov 9
TI  - Trends in newborn umbilical cord care practices in Sokoto and Bauchi States of 
      Nigeria: the where, who, how, what and the ubiquitous role of traditional birth 
      attendants: a lot quality assurance sampling survey.
PG  - 368
LID - 10.1186/s12884-017-1551-x [doi]
LID - 368
AB  - BACKGROUND: Neonatal infections caused by unsafe umbilical cord practices account 
      for the majority of neonatal deaths in Nigeria. We examined the trends in 
      umbilical cord care practices between 2012 and 2015 that coincided with the 
      introduction of chlorhexidine digluconate 7.1% gel in Bauchi and Sokoto States. 
      METHODS: We obtained data from three rounds of lot quality assurance samples 
      (LQAS) surveys conducted in 2012, 2013 and 2015. Households were randomly sampled 
      in each round that totaled 1140 and 1311 households in Bauchi and Sokoto States 
      respectively. Mothers responded to questions on cord care practices in the last 
      delivery. Coverage estimates of practice indicators were obtained for each survey 
      period. Local Government Area (LGA) estimates for each indicator were obtained 
      with alpha </= 5%, and beta </=20% statistical errors and aggregated to State-level 
      estimates with finite sample correction relative to the LGA population. RESULTS: 
      Over 75 and 80% of deliveries in Bauchi and Sokoto States respectively took place 
      at home. The proportion of deliveries in public facilities reported by mothers 
      ranged from 19% in 2012 to 22.4% in 2015 in Bauchi State and from 12.9 to 13.2% 
      in 2015 in Sokoto State. Approximately 50% of deliveries in Bauchi and more than 
      80% in Sokoto States were assisted by traditional birth attendants (TBAs) or 
      relatives and friends, with little change in the survey periods. In Bauchi and in 
      Sokoto States, over 75% and over 80% of newborn cords were cut with razor blades 
      underscoring the pervasive role of the TBAs in the immediate postpartum period. 
      Use of chlorhexidine digluconate 7.1% gel for cord dressing significantly 
      increased to the highest level in 2015 in both States. Health workers who 
      attended deliveries in health facilities switched from methylated spirit to 
      chlorhexidine. There were no observable changes in cord care practices among the 
      TBAs. CONCLUSION: Unsafe umbilical cord care practices remained prevalent in 
      Bauchi and Sokoto States of Nigeria, although a recent introduction of 
      chlorhexidine digluconate 7.1% gel positively changed the cord care practices 
      toward safer practices among public health providers. TBAs, friends and relatives 
      played the strongest immediate postpartum roles and mostly retained the unsafe 
      cord care practices such as use of ash, cow dung and hot compress. We recommend 
      that existing TBAs are retrained and refocused to forge stronger links between 
      communities and the primary health centers to increase mothers' access to skilled 
      birth attendants.
FAU - Abegunde, Dele
AU  - Abegunde D
AUID- ORCID: 0000-0002-7775-288X
AD  - Targeted States High Impact Project (TSHIP), JSI Research & Training Institute, 
      Inc., Bauchi, Bauchi State, Nigeria. dele.abegunde@yahoo.com.
FAU - Orobaton, Nosa
AU  - Orobaton N
AD  - Targeted States High Impact Project (TSHIP), JSI Research & Training Institute, 
      Inc., Bauchi, Bauchi State, Nigeria.
FAU - Beal, Katherine
AU  - Beal K
AD  - JSI Research & Training Institute, Inc, Boston, USA.
FAU - Bassi, Amos
AU  - Bassi A
AD  - Targeted States High Impact Project (TSHIP), JSI Research & Training Institute, 
      Inc., Bauchi, Bauchi State, Nigeria.
FAU - Bamidele, Moyosola
AU  - Bamidele M
AD  - Targeted States High Impact Project (TSHIP), JSI Research & Training Institute, 
      Inc., Bauchi, Bauchi State, Nigeria.
FAU - Akomolafe, Toyin
AU  - Akomolafe T
AD  - Targeted States High Impact Project (TSHIP), JSI Research & Training Institute, 
      Inc., Sokoto, Sokoto State, Nigeria.
FAU - Ohanyido, Francis
AU  - Ohanyido F
AD  - Targeted States High Impact Project (TSHIP), JSI Research & Training Institute, 
      Inc., Bauchi, Bauchi State, Nigeria.
AD  - Targeted States High Impact Project (TSHIP), JSI Research & Training Institute, 
      Inc., Sokoto, Sokoto State, Nigeria.
FAU - Umar-Farouk, Olayinka
AU  - Umar-Farouk O
AD  - Targeted States High Impact Project (TSHIP), JSI Research & Training Institute, 
      Inc., Abuja, Nigeria.
FAU - Danladi, Saba'atu
AU  - Danladi S
AD  - FUTURES- Targeted States High Impact Project (TSHIP), Bauchi, Bauchi State, 
      Nigeria.
LA  - eng
GR  - 620-A-00-09-00014-00/United States Agency for International Development/
PT  - Evaluation Study
PT  - Journal Article
DEP - 20171109
PL  - England
TA  - BMC Pregnancy Childbirth
JT  - BMC pregnancy and childbirth
JID - 100967799
RN  - 0 (Anti-Infective Agents, Local)
RN  - MOR84MUD8E (chlorhexidine gluconate)
RN  - R4KO0DY52L (Chlorhexidine)
SB  - IM
MH  - Anti-Infective Agents, Local/therapeutic use
MH  - Chlorhexidine/analogs & derivatives/therapeutic use
MH  - Delivery, Obstetric/methods/*statistics & numerical data
MH  - Female
MH  - Humans
MH  - Infant, Newborn
MH  - *Lot Quality Assurance Sampling
MH  - Midwifery/methods/standards/*trends
MH  - Nigeria
MH  - Perinatal Care/methods/standards/*trends
MH  - Pregnancy
MH  - Surveys and Questionnaires
MH  - Umbilical Cord
PMC - PMC5680596
OTO - NOTNLM
OT  - Chlorhexidine
OT  - Nigeria
OT  - Traditional birth attendants
OT  - Umbilical cord practices
COIS- ETHICS APPROVAL AND CONSENT TO PARTICIPATE: Ethical clearances for this study 
      were obtained from the Bauchi and Sokoto States' Health Research Ethics Review 
      Committees. Clearance was obtained for each of three rounds of surveys. In each 
      survey, confidentiality policy was explained to all respondent mothers or 
      caregivers of the sampled children including their right to decline participation 
      without any risk of any form of retribution, before obtaining informed consent 
      signed by thumb printing. Thumb printing was used to signify verbal consent 
      because of poor literacy rates among women in the regions where this study was 
      carried out. Majority of women have no formal education and cannot read or write. 
      CONSENT FOR PUBLICATION: Not applicable. COMPETING INTERESTS: The authors declare 
      that they have no competing interests. PUBLISHER'S NOTE: Springer Nature remains 
      neutral with regard to jurisdictional claims in published maps and institutional 
      affiliations.
EDAT- 2017/11/11 06:00
MHDA- 2018/07/11 06:00
PMCR- 2017/11/09
CRDT- 2017/11/11 06:00
PHST- 2015/09/29 00:00 [received]
PHST- 2017/10/31 00:00 [accepted]
PHST- 2017/11/11 06:00 [entrez]
PHST- 2017/11/11 06:00 [pubmed]
PHST- 2018/07/11 06:00 [medline]
PHST- 2017/11/09 00:00 [pmc-release]
AID - 10.1186/s12884-017-1551-x [pii]
AID - 1551 [pii]
AID - 10.1186/s12884-017-1551-x [doi]
PST - epublish
SO  - BMC Pregnancy Childbirth. 2017 Nov 9;17(1):368. doi: 10.1186/s12884-017-1551-x.